A Novel Application of the Hemostatic Net in Aesthetic Breast Surgery: A Preliminary Report.

BACKGROUND: Obtaining optimum breast aesthetics can be challenging in secondary aesthetic breast surgery, particularly with poor-quality skin, when downsizing implants, and in cases where patients will not accept additional mastopexy scars. Most techniques described in these cases rely on internal suturing and capsulorrhaphy, which can lack precision in tailoring the skin over the internal pocket. OBJECTIVES: The aim of this study was to present the authors' experience with utilizing the hemostatic net to help address a range of challenging breast cases in their practices. METHODS: A multicentre retrospective analysis of patients undergoing aesthetic and reconstructive breast surgery between 2019 and 2021 was conducted. A database was established to record patient demographics, indications for surgery, surgical technique, and complications. Following capsulorrhaphy, the hemostatic net was applied in as many rows as required with monofilament sutures and removed 3 to 7 days postoperatively. RESULTS: Twenty-four women (aged 23-67 years) underwent aesthetic or reconstructive breast surgery with the hemostatic net. This approach optimized stabilization of the inframammary fold and redraping of lax skin or irregularities in the skin envelope. At follow-up review, only 1 instance of the net failing to successfully redrape the skin was seen. CONCLUSIONS: The application of the hemostatic net is an option for patients who might otherwise require mastopexy but refuse to accept the scars. The technique has now been extended to primary cases where implant malposition or skin tailoring issues are anticipated, thus securing its place as a part of the surgical armamentarium.

Corrigendum to "Successful use of intrapelvic Quikclot in life-threatening blast injury" [Trauma Case Rep. 12 (2017) 59-62].

[This corrects the article DOI: 10.1016/j.tcr.2017.10.021.].

Successful use of intrapelvic Quikclot in life-threatening blast injury.

Patients that suffer multiple traumatic injuries often present with uncontrollable haemorrhage and rapidly descend into a viscous death triad consisting of hypothermia, coagulopathy and acidosis. Initial surgical intervention does not aim to provide conclusive repair, but instead strives to stop blood loss while priority is given to correct the patient's metabolic state (Duchesne et al., 2010). However in some cases of massive polytrauma, gaining surgical control of bleeding can be incredibly difficult. As a result a number of topical haemostatic agents were developed for use in military and civilian settings. This case details a successful intracavity use of the granular haemostatic agent, Quikclot™ (Z-Medica), in halting massive haemorrhage in a patient who sustained major blast injuries. Although not officially recommended, intracorporeal uses of Quikclot™ can be effective as a last resort in preventing loss of life in cases of severe polytrauma. However, users need to remain wary of complications which may arise due to its application.